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Drug May Be Non-Antibiotic Various to Deal with UTIs

FRIDAY, March 11, 2022 (HealthDay Information) — Girls suffering from frequent urinary tract infections usually take day by day antibiotics to ward them off. However an outdated antibiotic various would possibly work simply as nicely, a brand new scientific trial finds.

Researchers discovered that the treatment, referred to as methenamine, was comparable to straightforward, low-dose antibiotics in stopping girls’s recurrent urinary tract infections (UTIs). Both remedy curbed the infections to round one per 12 months, on common.

Methenamine is a long-established treatment that works by making the urine extra acidic and stopping bacterial progress. Research have proven that it may possibly stop recurrent UTIs, but it surely’s not extensively used.

It is such an “outdated” drug, many medical doctors at this time have no idea about it, stated Dr. Karyn Eilber, a urologist at Cedars-Sinai Medical Heart in Los Angeles.

Eilber, who was not concerned within the new research, stated she reserves day by day antibiotics as a final resort for stopping recurrent UTIs, favoring methenamine as a substitute.

A priority with day by day antibiotic use is feeding antibiotic resistance, the place micro organism study to thwart the medicines used to kill them. Plus, Eilber stated, it disrupts the physique’s regular bacterial steadiness.

Dr. Chris Harding, a marketing consultant urological surgeon at Freeman Hospital in the UK, led the trial.

He stated it “provides supportive proof for using methenamine and can be significantly welcome to these girls with recurrent UTI who need to keep away from long-term antibiotic remedy.”

UTIs are exceedingly frequent and may have an effect on anybody, however are significantly prevalent amongst girls. Research counsel as much as 80% of ladies develop a UTI in some unspecified time in the future, and about one-quarter of these girls go on to have frequent recurrences.

Some signs embrace burning throughout urination, and feeling a robust, persistent urge to urinate.

The brand new research — printed on-line March 9 within theBMJ— concerned 240 girls with recurring UTIs. In the beginning, they had been averaging round six UTIs per 12 months.

Half of the ladies had been randomly assigned to day by day low-dose antibiotic remedy, whereas the opposite half took methenamine twice a day.

Over one 12 months of remedy, each teams noticed a big decline in UTI episodes. Girls within the antibiotic group averaged just below one bout per particular person for the 12 months, whereas these taking methenamine had simply over one episode per particular person.

That could be a small distinction, Harding stated, and one which, based mostly on affected person focus teams, wouldn’t be thought-about “clinically significant.”

As for unwanted side effects, a small variety of girls in every group reported issues like nausea, stomach ache and diarrhea. Six girls developed a UTI with fever, and 4 wanted to be hospitalized — all of whom had been within the methenamine group.

Whether or not treating extra UTIs with methenamine will assist battle the issue of antibiotic resistance is an open query. In the course of the one 12 months of remedy on this trial, girls on antibiotics had been extra more likely to harbor micro organism immune to at the least one antibiotic. However that modified when their micro organism had been sampled six months later: Those that had taken methenamine had extra antibiotic-resistant bugs.

Harding stated that discovering “ought to be interpreted with warning,” for the reason that trial was not primarily geared toward gauging antibiotic resistance.

“Additional analysis is unquestionably indicated on this space,” he stated.

For now, girls ought to know there are alternatives for stopping frequent UTIs, the consultants stated.

“Low-dose antibiotics ought to positively not be the primary line,” Eilber stated.

Moreover methenamine, one other various is to take an antibiotic solely after intercourse. (Sexual exercise can encourage UTI-causing micro organism to maneuver into the urethra, the tube that releases urine from the physique.)

For postmenopausal girls, Eilber stated, vaginal estrogen could assist stop recurrent UTIs. After menopause, the vaginal tissue modifications in ways in which could foster the expansion of “dangerous” micro organism.

Consultants additionally typically advise some self-care steps that may assist, like consuming loads of water, urinating earlier than and after intercourse, and wiping entrance to again after utilizing the lavatory.

Most of the girls within the present trial had been going by way of or previous menopause. However, Harding stated, his workforce didn’t have a look at the results of remedy in accordance with age. Nor did the research embrace males. So it is not clear whether or not the findings would apply to older adults, one other group at elevated threat of recurrent UTI.

The research was funded by the U.Okay. Nationwide Institute for Well being Analysis.

Extra info

The U.S. Workplace on Girls’s Well being has extra on urinary tract infections.

SOURCES: Chris Harding, MD, marketing consultant urological surgeon, Freeman Hospital, Newcastle upon Tyne, U.Okay.; Karyn Eilber, MD, urologist, Cedars-Sinai Medical Heart, Los Angeles; BMJ, March 9, 2022, on-line

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